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Genetic predisposition, baseline anxiety history, and dosing speed significantly influence individual risk

In posterior segments of the gut (e.g., the cecum and proximal large intestine), gut microbes directly cleave the CN bond of carnitine to release TMA, which subsequently enters the liver through the portal circulation, is converted to TMAO by hepatic flavin monooxygenases (FMOs) [242, 243], and eventually enters the blood circulation [244]

The scientific literature is presently woefully short of research in this area